| NPI | 1912475419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: VA VA2305203045) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: DC PT870156) |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2018-11-02 |